LTC for new grad RN?

Nascar nurse, ASN, RN · Jun 18, 2011

Don't be afraid to ask the CNA's for advice too when appropriate. They are also a wealth of information. I have been a DON for 2 whole months (a nurse in LTC for 25+ years tho). At my new place of employment, one of my first priorities was to figure out who the "good" staff were - RN, LPN, CNA. Had 2 of the best CNA's in my office today asking for their opinion of how to best go about getting some things done that are missing. They had a lot to say and gave great advice. Plan to put their ideas into my grand plan.

My best advice to you. Take the job and become a sponge. Ask for additional orientation as 3 days is really not enough for a brand new grad. Don't ever be afraid to admit what you don't know.

Despite what some will tell you, LTC can be a great place to learn skills and critical thinking. As an LTC nurse, we do IV's, IV medications, trachs, complex wound care with with/without wound vacs, perotoneal dialysis, TPN, etc.

Good luck.

guest358111 · Jun 18, 2011

Oh I would encourage you to take it! Thirty residents with a medication aide....sounds ok to me! And doing assessments...you might be surprised at just how much you can learn. :) Just ask for orientation, and go with the flow...:)

robby5313 · Jun 18, 2011

I agree that you should accept. I started in LTC as an LPN and the CNA's were so helpful! Give them your respect and they will help you and save your A*& if needed! If you are respectful, most will help you however they can....**** them off and you will suffer, believe me! I learned so much just working as an LPN. We didn't have very many IV's, but lots of other things from A-Z. Don't be afraid to ask your other nurses for advice/help, etc. Hopefully you will have nurses who have experience that you can draw from. I carried alot of reference books with me, labs, procedures, etc. so if there was something I wasn't familiar with but needed to be done, I had a reference to guide me. (lord knows our facility did not have procedure or policy manuals). If you have a med aide you have it made! I finally gave up on LTC after 12 years because I was working night shift and the ONLY nurse for 120 residents. I had 2 med aides but as I said, the only nurse in the building. Twice I had 2 serious incidents at the same time. One a blood sugar that didn't even register, one was a resident who had fallen. Another time was a low blood sugar and a resident in respiratory distress. I had to do blood sugars on about 30 residents at 6:00 a.m. as well. Many times I was there until 9 a.m. charting. You will get better as you have to deal with things. Situations will come up and you will learn from them. There will be times when you make the right decision and times when you realize you could have handled things better. That will happen. I also had management that didn't give a crap about the nurses unless you were in management. There was an LPN who worked there for 25 years and always had special privledges. NEVER EVER had to work the med cart, even when she had no med aide, ALWAYS got out on time, NEVER made a mistake--even when it was pointed out to her. Gave report at the nurses station in the a.m. while residents were sitting at the nurses station. (This was pointed out to the DON and guess what? Still continued to happen.) She was beyond reproach. The golden child. Still works there to my knowledge. Made nurses and CNA's quit she was so mean. As I said, the golden child could do no wrong! 30 residents is not unreasonable. Not at all!

Heart 2 serve · Sep 14, 2011

I'm going to go against the grain and suggest that you accept this job offer.
30 residents with a medication aide to pass all your pills is a dream come true for the average LTC nurse. You would only be responsible for injections, finger stick blood sugars, breathing treatments, wound care, assessments, and charting. Without the medication aide, you would have to complete all of the aforementioned tasks in addition to passing oral medications to 30 residents x2 (at least two med passes per shift). Oral medication pass is the most time-consuming task of the LTC charge nurse, and I loved having a medication aide to take the load off me.
A charge nurse in LTC is different than a hospital charge nurse. LTC charge nurses are in charge of their hall, their residents, and the CNAs who work on their hall that day. They are not in charge of other nurses unless they carry the title of unit manager, house supervisor, or ADON (assistant director of nursing). In my area, every floor nurse in LTC is designated the charge nurse of their hall.
Your option is to take this job or continue to be unemployed. I would take it.

If you don't mind me asking what did you start off with as a new grad and what kind of benefit package did u receive?

Heart 2 serve · Sep 15, 2011

This is a follow-up post from a couple weeks back. I had posted "Am I setting myself up for failure" after being offered a weekend supervisor position in an LTC facility. I do have some experience working in a clinic over the last year, but nothing really in the way of skills. I graduated nursing school (RN) one year ago. After most of the responses told me that I might place myself in a position of losing my license, being inexperienced, I decided to decline the offer.
Now I am still out of work and no hospitals are calling me. The same facility would like for me to work now as a "Charge RN", not a weekend supervisor. They said that basically I would be over a hall of 30 residents and do assessments on Medicare clients and new admits, giving meds and treatments that the medication aides are not able to give, and paperwork. I would be responsible if there is a fall in determining what is to be done and in a code situation.
Is this really that different from the weekend supervisor in terms of being risky for my license. Would this be valuable experience that I could possibly transfer to a hospital someday?
Thanks in advance. I tried commenting on my old post but no replies so far.

I am in a similar predicament and was wondering what are the average per hour pay for this position? And where are you located? I'm trying to compare so I am aware of the current NEW GRAD charge nurse position salary.

Anything will help. Much thanks in advance! Hope all is going well with your job!

LyssC_RN · Aug 2, 2014

Most people were saying that my inexperience as a nurse would place me in a precarious position of losing my license because all responsibility would be on my shoulders. Prior to nursing school, I was not an LVN or CNA and I feel since I have not used any of my skills learned in clinicals, I have forgotten everything. They said there would be three days of orientation which does not seem like a whole lot, but that there was plenty of staff to back me up. Just don't know what to do. It just seems like maybe I would need med-surg experience first to be able to make critical decisions like whether someone needed to go to the hospital or not? Or am I being too overly cautious?

hm I have been a charge nurse and med nurse for over a month for a floor of 40 residents. And even I received 10days of orientation, and there were STILL things which eluded me. I can't imagine just three days of orientation. Maybe with just a straight up medication nurse position.

Anna S, RN · Aug 2, 2014

I would take the job, but I would suggest asking for a longer orientation.